Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
Natalia Valdiviezo , Nathaly Poma Nieto , Victor Paitan Amaro , Connie Rabanal , Jule Franve Vasquez Chavez , Luis Mas
Background: Cervical cancer is the most common malignancy in women in Peru. The standard primary treatment of locally advanced disease is chemo-radiation. The election drug is platinum salts, clinical guidelines recommend cisplatin. In some institutions Carboplatin is commonly used because of its safe toxicity profile and its synergy with radiation reported in other malignancies, besides it is not clear use of it. In this study we want to report our experience using Carboplatin and cisplatin concurrent to radiotherapy in terms of response rates and toxicity. Methods: Retrospective observational analysis. Our main objective was to compare the response rate and toxicity profile between Carboplatin and cisplatin chemo-radiation in women older than 18 years old, with diagnosis by biopsy of locally advanced cervical cancer ( stages Ib2 – IVA) of the “Instituto nacional de enfermedades neoplasicas”, Lima ,Peru in 2014 and 2015. The stage was determined clinical evaluation and abdominal- pelvic CT. We determined two arms; cisplatin 40 mg/m2 per week for 5 weeks and Carboplatin 2AUC per week for 5 weeks. Both groups were concurrent with radiotherapy. Results: We evaluated 250 patients, 121 were in the carboplatin arm and 129 patients in the cisplatin arm. The groups have similar characteristics. The median age was 50.9 years. In cisplatin arm, histologic type was squamous cell carcinoma 93%, IIB 75% and IIIB 21%, with complete response rate of 85%. In carboplatin arm the histologic type was squamous cell carcinoma 91%, there were stage IIB 62% and IIIB 31%, with complete response rate 71%. The toxicity profile in cisplatin arm was non haematological grade 2- 3: diarrhea 25%, emesis 23% and haematological grade 1- 2 anemia 31%, neutropenia 27%, thrombocytopenia 6%. The toxicity in carboplatin arm was non haematological grade 2- 3: renal 4%, diarrhea 15%, emesis 18% and haematological grade 1- 2 anemia 37%, neutropenia 27%, trombocitopenia 6%. The overall survival and disease free survival are ongoing. Conclusions: Our study found that carboplatin is an active agent with an acceptable toxicity profile. This intervention remains to be clarified with following-up.
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